1 Introduction
1. The NHS in England has embarked on a period of
substantial change. The requirement to deliver a 4% efficiency
gain, four years running (the "Nicholson Challenge")
is creating unprecedented demands on all staff of the service;
at the same time there is considerable uncertainty about the future
management structure of the service. Yet despite this uncertainty,
the Committee is reminded of the dedication and professionalism
of the NHS workforce, even when radical change is underway.
2. Patients have the expectation of, and are frequently
given, world class care and treatment by the NHS. Sometimes experience
falls well below the high standards expected, and when this happens
patients should have access to a responsive and effective complaints
system. However, the NHS complaints system sometimes compounds
and exacerbates the negative experiences of patients. In such
situations, patients have little choice but to give up or turn
to the legal system. It is worth noting that the motivation of
complainants is often not to seek compensation for failures of
care but rather to have their concerns listened to and acted upon
in order to reduce the likelihood of similar failings happening
again.
3. The Committee has taken evidence from people who
have complained about the failures in the care, treatment and
professional standards given by Mid Staffordshire NHS Foundation
Trust and in other NHS provider organisations in England. However,
our report has been prepared before we have learned the outcome
of the Mid Staffordshire inquiry and we are not seeking to reach
judgements on what happened there. We thank those who gave evidence
before the Committee for their bravery, and for the valuable contribution
that they have made. We also thank the many other people who have
sent us written submissions detailing the failings in care that
they have experienced. Other reports into failures in the NHS
have also informed our work, including the Shipman, Neale and
Ayling inquiries.[2]
4. There are unwarranted variations in how the complaints
system works across England, some elements of the system are ineffective,
and the cultures that exist often do not support effective resolution
and redress. The Committee's objective is to look at how the complaints
system can be further strengthened to give good and timely outcomes
for patients, contain the costs of litigation and ensure that
the NHS learns from complaints; it is a key objective that the
experience derived from proper consideration of complaints should
lead to changes and improvements in the care available to other
patients. The Committee recognises that complaints are only one
form of patient experience feedback and that many other, less
adversarial, means to give feedback about the NHS are available
to patients.
2 The independent public inquiry into the issues arising
from the case of Harold Fredrick Shipman, the independent investigation
into how the NHS handled allegations about the conduct of Clifford
Ayling and the investigation into how the NHS handled allegations
about the performance and conduct of Richard Neale. Back
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